Effects of social support on mental health for critical care nurses during the coronavirus disease 2019 (COVID-19) pandemic in Japan: A web-based cross-sectional study

The prevalence and risk factors of PTSD symptoms among nurses during the COVID-19 pandemic-A systematic review and meta-analysis

Since the first reported outbreak in China, the Coronavirus disease 2019 (COVID-19) has raised serious concerns globally. The COVID-19 pandemic has caused a severe psychological impact on healthcare workers (HCWs), and especially nurses, who are the most numerous and exposed frontline group. This systematic review and meta-analysis aims to summarise extant literature on the effects of the COVID-19 pandemic on the psychological health of nurses, particularly concerning the prevalence and risk factors for post-traumatic stress disorder (PTSD). A systematic search was conducted on PubMed, Embase and PsycInfo from March 2020 to July 2023. Articles were included/excluded on predetermined eligibility criteria. A random-effect meta-analysis was performed using proportions to determine the pooled prevalence for PTSD among nurses. Subgroup analyses were also performed, and heterogeneity across studies was analysed using meta-regression. Relatively high prevalence rates of PTSD were reported among nurse populations during the COVID-19 pandemic in twenty-six different countries, globally. Risk factors associated with PTSD include having prior mental health co-morbidities, being a female, having high exposure/contact with COVID-19 patients, having insufficient protective conditions and having intensive workloads. The overall pooled prevalence was 29.1% (95% C.I. = 23.5%, 35.5%) using a random-effects model in 55 studies. The regression test of funnel plot asymmetry indicated a significant level of publication bias among studies. The COVID-19 pandemic is associated with significant levels of PTSD among frontline nurses globally. A high level of heterogeneity was observed across studies. Psychological, social and administrative interventions should be implemented to mitigate heavy psychological distress in nurses.

Mediating effects of social support and presenteeism on turnover intention and post-traumatic stress disorder among Chinese nurses in the post-pandemic era: a cross-sectional study

Background

The shift in national policies for epidemic prevention and control in the post-pandemic era is undoubtedly a challenge for health care professionals. Nurses, as an important part of the health care professional population, have an even greater impact on their mental health and occupational safety. This may expose nurses to post-traumatic stress disorder (PTSD) and presenteeism, and ultimately lead to their turnover.

Objective

This study aimed to investigate the relationship between turnover intention and post-traumatic stress disorder among Chinese nurses during post-pandemic era, and the mediating role of social support and presenteeism.

Methods

In this study, a multicentre cross-sectional survey was conducted in April 2023 among nursing staff in several tertiary general hospitals in northern China, with online data collection using the Turnover intention Scale (PTSD), the Impact of Events Scale (IES), the Social Support Scale (SSS), and the Stanford presenteeism Scale (STAS) and the relationship between variables was analyzed using hierarchical multivariate regression, and Structural Equation Modeling (SEM) was used to analyze the relationship between post-traumatic stress disorder and the Turnover intention from the pathway between.

Results

Data were collected from 2,513 nurses who met the inclusion criteria, in which general information such as age, department, specific department, Professional title, history of alcohol consumption, form of employment, Years of working, and Average working hours per day were statistically significant with the difference in the turnover intention. The results of the study showed a 32% high turnover intention among nurses in the post-pandemic era, which was lower than the turnover intention during the pandemic. The results of hierarchical multiple regression analysis showed that post-traumatic stress disorder, social support, and presenteeism were significant predictors of turnover intention. The total effect of post-traumatic stress disorder on turnover intention to work was 0.472 [bias modified 95% confidence interval (0.415-0.483), p < 0.001]. Social support and attendance played a partially intermediate role in post-traumatic stress disorder and propensity to leave (an indirect effect of 26% of the total effect).

Conclusion

Turnover intention and post-traumatic stress disorder levels are high and social support plays an important role in the tendency to leave the job and post-traumatic stress disorder, healthcare institution can be achieved by strengthening social support for nurses in the post-epidemic era and preventing the occurrence of presenteeism.

Effects of Career Adaptability and Self-Efficacy on Transition Shock Among Newly Graduated Nurses During the COVID-19 Pandemic: A Survey Conducted in China

BACKGROUND

The coronavirus disease 2019 (COVID-19) outbreak has increased the work pressure of nurses worldwide, and managers must provide support and assistance for the transition period of newly graduated nurses.

METHOD

A cross-sectional design was adopted to collect a sample of 318 newly graduated nurses from six hospitals in China during the COVID-19 pandemic. Data were collected using a questionnaire that consisted of a demographic questionnaire, the Transition Shock Scale (2015), the Career Adapt-Ability Scale (2012), and the General Self-Efficacy Scale (2001).

RESULTS

The transition shock of newly graduated nurses was 3.77 ± 0.48 in China. Regression analysis showed that transition shock among newly graduated nurses was predicted by career adaptability, general self-efficacy, living with one's parents, and education level, which accounted for 37.7% of the variance in transition shock.

CONCLUSION

Newly graduated nurses experienced a relatively high level of transition shock in China during the COVID-19 pandemic. Managers may offer continuing education to reduce the transition shock of newly graduated nurses based on the factors that affect their transition shock. [J Contin Educ Nurs. 2023;54(11):524-532.].

Current status of post-traumatic stress disorder among emergency nurses and the influencing factors

Objective

To gain a better understanding of the current state of traumatic stress experienced by emergency nurses of Grade III Level A hospitals in Jiangsu Province, as well as their coping styles after experiencing such traumatic events. Additionally, this study aims to identify the primary factors that influence the responses of these nurses to traumatic events.

Methods

Using a cluster random sampling method, we enrolled 265 nurses working in the emergency departments of five Grade III Level A hospitals in Jiangsu Province. These nurses participated in a questionnaire survey that included inquiries regarding general information, previous traumatic experiences, and a post-traumatic stress disorder self-assessment scale (PCL-C) for emergency department nurses.

Results

A total of 290 questionnaires were distributed, resulting in 265 valid questionnaires and an effective rate of 91.38%. These findings indicated that emergency nurses who participated in public health emergencies such as the COVID-19 pandemic (45.66%) and sudden health deterioration and death of patients (43.77%) encountered the most traumatic events. The top two traumatic events that had a moderate or greater impact on emergency nurses were verbal abuse from patients or their family members (39.24%) and verbal or physical threats by patients or their family members (35.09%). The mean PCL-C score of nurses who experienced traumatic events was 33.62 ± 11.37, with a positive rate of 26.04%. Results from the one-way analysis of variance and multiple linear regression analysis demonstrated that the working years, monthly income, and personal health status of emergency nurses were the main factors contributing to post-traumatic stress disorder.

Conclusion

Emergency nurses are susceptible to severe traumatic stress following traumatic events, and effective interventions are necessary to address the diverse factors that contribute to their psychological well-being.

Time perspective predicts levels of anxiety and depression during the COVID-19 outbreak: A cross-cultural study

The COVID-19 outbreak and governmental measures to keep the population safe had a great impact on many aspects of society, including well-being. Using data from N = 1281 participants from six countries (Argentina, France, Greece, Italy, Japan, and Turkey), we first explored differences in anxiety, depression (measured with the Hospital Anxiety and Depression Scale; HADS), and time perspectives (Zimbardo Time Perspective Inventory; ZTPI), between these countries during the first weeks of the pandemic. We observed that Turkish participants reported the highest levels of anxiety, and Japanese and Greek the lowest. For depression symptoms, the Japanese scored highest and Italians lowest. Next, for each country, we investigated how well the relatively time-stable personality traits of time perspectives, chronotype (reduced Morningness-Eveningness Questionnaire; rMEQ), and Big Five personality traits (short Big Five Inventory; BFI) predicted the levels of anxiety and depression (HADS). The regression analyses showed that negative attitudes towards the past predicted the levels of both anxiety and depression in most of the countries we analyzed. Additionally, in many countries, a Past Positive orientation negatively predicted depression whereas the Present Fatalistic subscale predicted anxiety and depression. The chronotype did not contribute additionally to the models. The Big Five traits (and particularly neuroticism) showed substantial incremental explanatory power for anxiety in some countries but did not consistently predict anxiety levels. For depression, the additional variance accounted for by including the BFI as predictors was rather small. Importantly, the ZTPI subscales were retained as significant predictors in the model still when the BFI and rMEQ were considered as potential predictors. Our results yield evidence that the ZTPI time perspectives are valuable predictors for anxiety and depression levels during the first period of the pandemic.

Role Stress and Psychological Distress Among Chinese Nurses During the COVID-19 Pandemic: A Moderated Mediation Model of Social Support and Burnout

OBJECTIVE

Nurses are at high risk of psychological distress including stress, depression, and anxiety due to low personnel density and high work demand. Despite mounting evidence showing that role stress is a risk factor for nurses' psychological distress, the mediating and moderating mechanisms underlying this relationship are less known. This study tests the mediation effect of burnout in the association between role stress and psychological distress, and whether this mediation is moderated by social support.

METHODS

A sample of 623 Chinese nurses were recruited from all hepatological surgery departments in Hunan Province and filled out an online questionnaire to collect data on socio-demographics, role stress, burnout, psychological distress, and social support. Mediation and moderation analyses were carried out in SPSS macro-PROCESS.

RESULTS

Burnout partially mediated the positive association between role stress and psychological distress. Social support moderated the indirect effect of role stress on psychological distress via burnout, with the effect being stronger for nurses with low social support than those with high social support.

CONCLUSIONS

These findings demonstrated how role stress contributed to nurses' psychological distress both directly and indirectly through burnout, and how this indirect effect was moderated by social support. The results provide important practical implications for future prevention and intervention programs to improve nurses' mental health from multiple aspects such as decreasing role stress and burnout while increasing social support.

Influence of Mutual Support on Burnout among Intensive Care Unit Healthcare Professionals

Introduction

Burnout among healthcare professionals in intensive care units (ICUs) is a serious issue that leads to early retirement and medication errors. Their gender, lower years of experience, and lower education have been reported as risk factors. Simultaneously, mutual support—commonly referred to as “back-up behavior,” in which staff members support each other—is critical for team performance. However, little is known about the influence of mutual support among ICU healthcare professionals on burnout. The U.S. Agency for Healthcare Research and Quality refers to mutual support as the involvement of team members in: assisting one another, providing and receiving feedback, and exerting assertive and advocacy behaviors when patient safety is threatened.

Objective

This study aimed to verify the hypothesis that lower mutual support among ICU healthcare professionals is associated with increased probability of burnout.

Methods

A web-based survey was conducted from March 4 to 20, 2021. All ICU healthcare professionals in Japan were included. An invitation was sent via the mailing list of the Japanese Society of Intensive Care Medicine and asked to mail to local communities and social network services. We measured burnout severity using the Maslach Burnout-Human Services Survey and mutual support using the TeamSTEPPS Teamwork Perceptions Questionnaire, as well as occupational background. The cutoff value for burnout was predefined and conducted logistic regression.

Results

We received 335 responses, all of which were analyzed. The majority of respondents were nurses (58.5%), followed by physicians (18.5%) and clinical engineers (10.1%). The burnout group scored significantly lower on mutual support than the non-burnout group. After adjusting for covariates in a logistic regression, low mutual support was an independent factor predicting a high probability of burnout.

Conclusions

This study suggests that it is important to focus on mutual support among ICU healthcare professionals to reduce the frequency of burnout.